Fine needle aspiration biopsy of thyroid nodules

Background-Fine needle aspiration biopsy (FNA) is a routine diagnostic tech nique for evaluating thyroid nodules. Many reports in adults consider that FNA is superior to thyroid ultrasonography (USG) and radionuclide scanning (RS). Only five studies have been published on FNA of childhood thyroid nod ules. Aims-To investigate the reliability of FNA in the evaluation and management of thyroid nodules, and compare the results of FNA, USG, and RS with regar d to final histopathological diagnosis. Methods-FNA was performed in 46 children with thyroid nodules after USG and RS examination. We investigated the sensitivity, specificity, accuracy, an d positive and negative predictive values of USG, RS, and FNA in their mana gement. Results-Six patients who had malignant or suspicious cells on FNA examinati on underwent immediate surgery. The other 40 patients received medical trea tment according to their hormonal status. Fifteen of these nodules either d isappeared or decreased in number and/or size. Surgery was performed in 25 patients who did not respond to therapy. Statistical analysis revealed sens itivity, specificity, accuracy, and positive and negative predictive values respectively as follows: 60%, 59%, 59%, 15%, and 92% for USG; 30%, 42%, 39 %, 12%, and 68% for SC; 100%, 95%, 95%, 67%, and 100% for FNAB. Conclusion- FNAB is as reliable in children as in adults for definitive diagnosis of th yroid nodules. Using this technique avoids unnecessary thyroid surgery in c hildren.